Evans, Sorcha

Brown, Brigid

Mathieson, Matthew

Tay, Stan

2014-05-30

Amniotic fluid embolism (AFE) is a rare and potentially fatal complication of pregnancy. In this case report, we highlight the successful use of sodium bicarbonate in a patient with an AFE. We present a case of a 38-year-old mother admitted for an elective caesarean section. Following the delivery of her baby, the mother suffered a cardiac arrest. Following a protracted resuscitation, transoesophageal echocardiography demonstrated evidence of acute pulmonary hypertension, with an empty left ventricle and an over-distended right ventricle. In view of these findings and no improvement noted from on-going resuscitation, sodium bicarbonate was infused as a pulmonary vasodilator. Almost instantaneous return of spontaneous circulation was noted, with normalisation of cardiac parameters. We propose that in patients suspected with AFE and who have been unresponsive to advance cardiac life support measures, and where right ventricular failure is present with acidosis and/or hypercarbia, the use of sodium bicarbonate should be considered.

Department of Anaesthesia, Townsville Hospital, Douglas, Queensland, Australia..

Department of Anaesthesia, Royal Darwin Hospital, Tiwi, Northern Territory, Australia..

Department of Anaesthesia, Royal Darwin Hospital, Tiwi, Northern Territory, Australia..

Department of Anaesthesia, Royal Darwin Hospital, Tiwi, Northern Territory, Australia..

BMJ case reports 2014-05-30; 2014

https://pubmed.ncbi.nlm.nih.gov/24879737/?otool=iaurydwlib

https://hdl.handle.net/10137/5590

Adult

Embolism, Amniotic Fluid

Female

Heart Arrest

Humans

Hypertension, Pulmonary

Pregnancy

Sodium Bicarbonate

Vasodilator Agents

Survival after an amniotic fluid embolism following the use of sodium bicarbonate.

Journal Article

Publication